Effect of cold provocation on vessel density in eyes with primary open angle glaucoma: An optical coherence tomography angiography study

The cold pressor test (CPT) induces a cardiovascular response, which may affect ocular blood flow and neuronal function. This study assessed whether optical coherence tomography angiography (OCT-A) can be used to evaluate CPT-induced changes in healthy eyes and in eyes with primary open-angle glaucoma (POAG). Twenty-two healthy subjects and 23 subjects with POAG and retinal fibre layer defects in only one hemifield were included in this study. The CPT was performed by submerging a subject’s hand in cold water (0–4 °C) for 1 minute. The results showed that baseline peripapillary and macular vessel density (VD) measurements were significantly lower in subjects with POAG than in controls (all P < 0.05). Post-CPT VD measurements did not significantly differ from baseline in either healthy or glaucomatous eyes. Additionally, CPT-induced changes in VD did not differ among normal eyes, damaged and undamaged glaucomatous hemifields. Changes in VD were also not significantly influenced by self-reported history of cold extremities. In conclusion, the CPT does not induce significant VD changes, as measured by OCT-A, in the peripapillary or macular areas of either healthy eyes or eyes with POAG. The VD, an all-or-nothing flow measure, may not be sensitive enough for evaluating cold-induced ocular haemodynamic changes.